Abstract
Objectives
To examine the association of FVI and frailty in Chinese elders.
Design
A sectional study was conducted in three cities (Shanghai, Zhengzhou, and Baoji) in China from June 2017 to June 2018.
Participants
A total of 5699 participants from 49 districts were included in the current study by two-stage sampling methods.
Measurements
Frailty was measured by a validated Chinese version of the FRAIL scale. FVI per day was measured by two single questions
Results
The sample proportion with sufficient fruit intake was 36.7%, and 44.7% reported sufficient vegetable intake. The sample proportions that were robust, pre-frail, and frail were 43.6%, 38.3%, and 18.1%, respectively. Compared with low FVI, after including covariates, the odds ratio (OR) of frailty was 0.84 (95% CI: 0.73–0.97) for moderate fruit intake and 0.81 (95% CI: 0.70–0.94) for enough fruit intake; the OR of frailty was 0.83 (95% CI: 0.68–0.91) for moderate vegetable intake and 0.77 (95% CI: 0.64–0.93) for enough vegetable intake.
Conclusion
High FVI was negatively associated with the OR of frailty in Chinese elders. This finding implies it is important to promote FVI among adults to prevent frailty.
Similar content being viewed by others
References
Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013 Jun;14:392–7.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013 Mar 2;381:752–62.
Dent E, Lien C, Lim WS, Wong WC, Wong CH, Ng TP, Woo J, Dong B, de la Vega S, et al. The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty. J Am Med Dir Assoc. 2017 Jul 1;18:564–75.
Cesari M, Prince M, Thiyagarajan JA, De Carvalho IA, Bernabei R, Chan P, Gutierrez-Robledo LM, Michel JP, Morley JE, et al. Frailty: An Emerging Public Health Priority. J Am Med Dir Assoc. 2016 Mar 1;17:188–92.
Feng Z, Lugtenberg M, Franse C, Fang X, Hu S, Jin C, Raat H. Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017;12:e0178383.
Bonnefoy M, Berrut G, Lesourd B, Ferry M, Gilbert T, Guerin O, Hanon O, Jeandel C, Paillaud E, et al. Frailty and nutrition: searching for evidence. The journal of nutrition, health & aging. 2015 Mar;19:250–7.
Yannakoulia M, Ntanasi E, Anastasiou CA, Scarmeas N. Frailty and nutrition: From epidemiological and clinical evidence to potential mechanisms. Metabolism. 2017 Mar;68:64–76.
Woo J. Nutrition and Frailty. The journal of nutrition, health & aging. 2018;22:1025–7.
Lorenzo-Lopez L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodriguez-Villamil JL, Millan-Calenti JC. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatr. 2017 May 15;17:108.
Kojima G, Avgerinou C, Iliffe S, Walters K. Adherence to Mediterranean Diet Reduces Incident Frailty Risk: Systematic Review and Meta-Analysis. J Am Geriatr Soc. 2018 Apr;66:783–8.
Zhan J, Liu YJ, Cai LB, Xu FR, Xie T, He QQ. Fruit and vegetable consumption and risk of cardiovascular disease: A meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2017 May 24;57:1650–63.
Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, Greenwood DC, Riboli E, Vatten LJ, Tonstad S. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017 Jun 1;46:1029–56.
Miller V, Mente A, Dehghan M, Rangarajan S, Zhang X, Swaminathan S, Dagenais G, Gupta R, Mohan V, et al. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study. Lancet. 2017 Nov 4;390:2037–49.
Kojima G, Avgerinou C, Iliffe S, Jivraj S, Sekiguchi K, Walters K. Fruit and Vegetable Consumption and Frailty: A Systematic Review. The journal of nutrition, health & aging. 2018;22:1010–7.
Society CN. Dietary Guidelines for Chinese(2016). Beijing: People’s Medical Publishing House; 2016.
Woo J, Yu R, Wong M, Yeung F, Wong M, Lum C. Frailty Screening in the Community Using the FRAIL Scale. J Am Med Dir Assoc. 2015 May 1;16:412–9.
Nie X, Zhu Y, Fu H, Dai J, Gao J. The “Dark Side” Effects of Social Capital on Harmful Drinking among Chinese Community Residents: A Multilevel Study. Int J Environ Res Public Health. 2018 Oct 15;15.
Chan R, Leung J, Woo J. Dietary Patterns and Risk of Frailty in Chinese Community-Dwelling Older People in Hong Kong: A Prospective Cohort Study. Nutrients. 2015 Aug 24;7:7070–84.
Garcia-Esquinas E, Rahi B, Peres K, Colpo M, Dartigues JF, Bandinelli S, Feart C, Rodriguez-Artalejo F. Consumption of fruit and vegetables and risk of frailty: a dose-response analysis of 3 prospective cohorts of community-dwelling older adults. Am J Clin Nutr. 2016 Jul;104:132–42.
Kobayashi S, Asakura K, Suga H, Sasaki S. Inverse association between dietary habits with high total antioxidant capacity and prevalence of frailty among elderly Japanese women: A multicenter cross-sectional study. The journal of nutrition, health & aging. 2015 2014/11/01;18:827–36.
Gobbens RJ, van Assen MA. Explaining frailty by lifestyle. Arch Gerontol Geriatr. 2016 Sep-Oct;66:49–53.
Johannesson J, Rothenberg E, Gustafsson S, Slinde F. Meal frequency and vegetable intake does not predict the development of frailty in older adults. Nutr Health. 2019 Mar;25:21–8.
Wu IC, Shiesh SC, Kuo PH, Lin XZ. High oxidative stress is correlated with frailty in elderly chinese. J Am Geriatr Soc. 2009 Sep;57:1666–71.
Soysal P, Isik AT, Carvalho AF, Fernandes BS, Solmi M, Schofield P, Veronese N, Stubbs B. Oxidative stress and frailty: A systematic review and synthesis of the best evidence. Maturitas. 2017 May;99:66–72.
Lampe JW. Health effects of vegetables and fruit: assessing mechanisms of action in human experimental studies. Am J Clin Nutr. 1999 Sep;70:475S–90S.
Soysal P, Stubbs B, Lucato P, Luchini C, Solmi M, Peluso R, Sergi G, Isik AT, Manzato E, et al. Inflammation and frailty in the elderly: A systematic review and meta-analysis. Ageing Res Rev. 2016 Nov;31:1–8.
Shivappa N, Stubbs B, Hébert JR, Cesari M, Schofield P, Soysal P, Maggi S, Veronese N. The Relationship Between the Dietary Inflammatory Index and Incident Frailty: A Longitudinal Cohort Study. Journal of the American Medical Directors Association. 2018;19:77–82.
Zhu F, Du B, Xu B. Anti-inflammatory effects of phytochemicals from fruits, vegetables, and food legumes: A review. Crit Rev Food Sci Nutr. 2018 May 24;58:1260–70.
Lauretani F, Semba RD, Bandinelli S, Dayhoff-Brannigan M, Giacomini V, Corsi AM, Guralnik JM, Ferrucci L. Low plasma carotenoids and skeletal muscle strength decline over 6 years. J Gerontol A Biol Sci Med Sci. 2008 Apr;63:376–83.
Cesari M, Pahor M, Bartali B, Cherubini A, Penninx BW, Williams GR, Atkinson H, Martin A, Guralnik JM, Ferrucci L. Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. Am J Clin Nutr. 2004 Feb;79:289–94.
Dawson-Hughes B, Harris SS, Ceglia L. Alkaline diets favor lean tissue mass in older adults. Am J Clin Nutr. 2008 Mar;87:662–5.
Kim J, Lee Y, Kye S, Chung YS, Kim KM. Association of vegetables and fruits consumption with sarcopenia in older adults: the Fourth Korea National Health and Nutrition Examination Survey. Age Ageing. 2015 Jan;44:96–102.
Hashemi R, Motlagh AD, Heshmat R, Esmaillzadeh A, Payab M, Yousefinia M, Siassi F, Pasalar P, Baygi F. Diet and its relationship to sarcopenia in community dwelling Iranian elderly: a cross sectional study. Nutrition. 2015 Jan;31:97–104.
Nicklett EJ, Kadell AR. Fruit and vegetable intake among older adults: a scoping review. Maturitas. 2013 Aug;75:305–12.
Kojima G, Liljas A, Iliffe S, Jivraj S, Walters K. A systematic review and meta-analysis of prospective associations between alcohol consumption and incident frailty. Age Ageing. 2018 Jan 1;47:26–34.
Kojima G, Jivraj S, Iliffe S, Falcaro M, Liljas A, Walters K. Alcohol Consumption and Risk of Incident Frailty: The English Longitudinal Study of Aging. J Am Med Dir Assoc. 2018 Nov 28.
Shah M, Paulson D, Nguyen V. Alcohol Use and Frailty Risk among Older Adults over 12 Years: The Health and Retirement Study. Clin Gerontol. 2018 Jul–Sep;41:315–25.
Sierksma A, van der Gaag MS, Kluft C, Hendriks HF. Moderate alcohol consumption reduces plasma C-reactive protein and fibrinogen levels; a randomized, diet-controlled intervention study. Eur J Clin Nutr. 2002 Nov;56:1130–6.
Stewart SH, Mainous AG, 3rd, Gilbert G. Relation between alcohol consumption and C-reactive protein levels in the adult US population. J Am Board Fam Pract. 2002 Nov-Dec;15:437–42.
WHO. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018.
Reid MC, Boutros NN, O’Connor PG, Cadariu A, Concato J. The health-related effects of alcohol use in older persons: a systematic review. Subst Abus. 2002 Sep;23:149–64.
Acknowledgments
This study was supported by National key R&D Program of China (grant number:2018YFC2002001).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical Standards: This study has been approved by the Institutional Review Board of Fudan University. The design and procedures of the study were performed in accordance with the principles of the Declaration of Helsinki.
Statement of Potential Conflict of Interest: No potential conflict of interest was reported by the authors.
Additional information
Financial disclosure: All authors have no financial disclosures.
Rights and permissions
About this article
Cite this article
Gao, J., Jia, Y., Dai, J. et al. Association of Fruit and Vegetable Intake and Frailty among Chinese Elders: A Cross-Sectional Study in Three Cities. J Nutr Health Aging 23, 890–895 (2019). https://doi.org/10.1007/s12603-019-1236-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-019-1236-4